The MELD scoring system for predicting prognosis in patients with severe hepatitis after plasma exchange treatment
The MELD scoring system for predicting prognosis in patients with severe hepatitis after plasma exchange treatment作者机构:Harbin Med Coll Dept Infect Dis Affiliated Hosp 2 Harbin 150086 Peoples R China Peking Univ First Hosp Dept Infect Dis Beijing 100034 Peoples R China
出 版 物:《Hepatobiliary & Pancreatic Diseases International》 (国际肝胆胰疾病杂志(英文版))
年 卷 期:2007年第6卷第5期
页 面:492-496页
核心收录:
学科分类:1002[医学-临床医学] 100201[医学-内科学(含:心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学]
基 金:Funding:This study was supported by a grant from the Science and Technology Research Foundation of the Department of Education Heilongjiang Province China (11511233)
主 题:severe hepatitis model for end-stage liver disease plasma exchange mortality
摘 要:BACKGROUND: Hepatic failure caused by severe hepatitis is a clinical syndrome where the major liver functions, particularly detoxification, synthetic functions, and metabolic regulation are impaired to different degrees, and may result in major life-threatening complications such as hepatic encephalopathy, ascites, jaundice, cholestasis, bleeding and hepatorenal syndrome. Plasma exchange (PE) has been found useful in treating patients with fulminant hepatic failure by removing hepatic toxins and replacement of clotting factors, so PE treatment has temporary supportive effects on liver failure caused by severe viral hepatitis. in this study, our aim was to predict the prognosis of patients with severe hepatitis after PE treatment using the end-stage liver disease (MELD) scoring system. METHODS: Two hundred and twenty patients were randomly divided into PE and control groups, and the MELD score was calculated for each patient according to the original formula. The efficacy of PE was assessed by mortality or improvement in biochemical parameters and MELD score. RESULTS: The levels of total bilirubin and international normalised ratio (INR) in patients whose MELD scores were between 30 and 39 were lower than those before PE treatment, as those in patients whose MELD scores were 40 or higher. The mortality of patients in the PE group with MELD scores from 30 to 39 was 50.0%, while it was 83.3% in the control group (P0.05). CONCLUSIONS: PE treatment can decrease the serum total bilirubin level and INR and MELD score of patients with severe hepatitis and improve liver function. Compared with the control group, PE can significantly decrease the mortality of patients with MELD scores from 30 to 39, but has no effect in patients with MELD scores of 40 or higher.